Skin cancer in the United States is a large and growing public concern. Non-melanoma skin cancer (NMSC) frequently occurs in sun-exposed areas such as the face. Two procedures that can be used to remove NMSC tumors are standard excision and Mohs surgery. Our study will compare these two surgical procedures for the treatment of facial NMSC skin in terms of cost, effectiveness, and impact on quality of life (QOL). Our goal is to determine which of the two procedures provides the highest cure rate, at the lowest cost while providing the greatest QOL. Issues such as these may be addressed analytically through the use of cost-effectiveness analyses (CEA). CEA are basic and essential tools used for evaluating health care practices. They measure the relative efficiency of one health care strategy as compared to that of the other strategies. Costs, efficacy, and outcomes are vital components of a CEA. CEA identify variables of the health care pathway that are important determinants of cost and/or outcome. Policy makers can then address these variables to convert a health care plan to a more cost-effective one. Our pilot data has provided the cost of the two types of surgical techniques.
The specific aims of the proposed project are two fold: the determination efficiency of the two procedures, and impact the procedures have on QOL. This will be done at Emory University where patients who have undergone Mohs surgery will be asked to complete a questionnaire about the impact the scars from a Mohs procedure have on their quality of life. Understanding that CEA compare both costs and outcomes, we hypothesize that Mohs surgery by is more cost-effective and provides greater QOL outcomes than standard surgical excision for facial NMSC.
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